scholarly journals Do ARISCAT scores help to predict the incidence of postoperative pulmonary complications in elderly patients after upper abdominal surgery? An observational study at a single university hospital

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jitsupa Nithiuthai ◽  
Arunotai Siriussawakul ◽  
Rangsinee Junkai ◽  
Nutthakorn Horugsa ◽  
Sunit Jarungjitaree ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Assessment Tool ◽  
Area Under The Curve ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Surgical Patients ◽  
Postoperative Pulmonary Complications ◽  
Duration Of Surgery ◽  
Upper Abdominal

Abstract Background The incidence of postoperative pulmonary complications (PPCs) is increasing in line with the rise in the number of surgical procedures performed on geriatric patients. In this study, we determined the incidence and risk factors of PPCs in elderly Thai patients who underwent upper abdominal procedures, and we investigated whether the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score helps to predict PPCs in Thais. Methods A retrospective study was conducted on upper abdominal surgical patients aged over 65 years who had been admitted to the surgical ward of Siriraj Hospital, Mahidol University, Thailand, between January 2016 and December 2019. Data were collected on significant PPCs using the European Perioperative Clinical Outcome definitions. To identify risk factors, evaluations were made of the relationships between the PPCs and various preoperative, intraoperative, and postoperative factors, including ARISCAT scores. Results In all, 1100 elderly postoperative patients were analyzed. Their mean age was 73.6 years, and 48.5% were male. Nearly half of their operations were laparoscopic cholecystectomies. The incidence of PPCs was 7.7%, with the most common being pleural effusion, atelectasis, and pneumonia. The factors associated with PPCs were preoperative oxygen saturation less than 96% (OR = 2.6, 1.2–5.5), albumin level below 3.5 g/dL (OR = 1.7, 1.0–2.8), duration of surgery exceeding 3 h (OR = 2.0, 1.0–4.2), and emergency surgery (OR = 2.8, 1.4–5.8). There was a relationship between ARISCAT score and PPC incidence, with a correlation coefficient of 0.226 (P < 0.001). The area under the curve was 0.72 (95% CI, 0.665–0.774; P < 0.001). Conclusions PPCs are common in elderly patients. They are associated with increased levels of postoperative morbidities and extended ICU and hospital stays. Using the ARISCAT score as an assessment tool facilitates the classification of Thai patients into PPC risk groups. The ARISCAT scoring system might be able to be similarly applied in other Southeast Asian countries.

Do ARISCAT Scores Help to Predict the Incidence of Postoperative Pulmonary Complications in Elderly Patients After Upper Abdominal Surgery? An Observational Study at a Single University Hospital.

2021 ◽  
Author(s):  
Jitsupa Nithiuthai ◽  
Arunotai Siriussawakul ◽  
Namtip Triyasunant ◽  
Rangsinee Junkai ◽  
Nutthakorn Horugsa ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Assessment Tool ◽  
Risk Groups ◽  
Pulmonary Complications ◽  
University Hospital ◽  
Surgical Patients ◽  
Postoperative Pulmonary Complications ◽  
Average Hospital ◽  
Hospital Stays ◽  
Upper Abdominal

Abstract BackgroundThe incidence of postoperative pulmonary complications (PPCs) is increasing in line with the rise in the number of surgical procedures performed on geriatric patients. In this study, we determined the incidence of PPCs in elderly Thai patients who underwent upper abdominal procedures, and we investigated whether the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score helps to predict PPCs in Thais.MethodsA retrospective study was conducted on upper abdominal surgical patients aged over 65 years who had been admitted to the surgical ward of Siriraj Hospital, Mahidol University, Thailand, between January 2016 and December 2019. Data were collected on significant PPCs using the European Perioperative Clinical Outcome definitions. To identify risk factors, evaluations were made of the relationships between the PPCs and various preoperative, intraoperative, and postoperative factors, including ARISCAT scores.ResultsIn all, 1,100 elderly postoperative patients were analyzed. Their mean age was 73.62 years, and 48.5% were male. The incidence of PPCs was 7.72%, with the most common being pleural effusion, atelectasis, and pneumonia. The average hospital and intensive care unit stays of the PPC patients were significantly longer than those without PPC (25.35 versus 7.30 days, with p < 0.0001; and 8.36 versus 2.84 days, with p 0.010, respectively). Almost 90% of the PPC patients had intermediate-to-high ARISCAT scores, with an average of 43.15 ± 13.58.ConclusionsPPCs are common in elderly patients and are associated with increased levels of postoperative morbidities and extended ICU and hospital stays. Using the ARISCAT score as an assessment tool facilitates the classification of geriatric Thai patients into PPC risk groups. Its usage might help to raise healthcare awareness and improve the perioperative management of elderly Thai patients. Moreover, the ARISCAT scoring system might be able to be similarly applied in other Southeast Asian countries.

scholarly journals Prospective assessment of the risk of postoperative pulmonary complications in patients submitted to upper abdominal surgery

1999 ◽  
Vol 117 (4) ◽  
pp. 151-160 ◽  
Author(s):  
Eanes Delgado Barros Pereira ◽  
Ana Luisa Godoy Fernandes ◽  
Meide da Silva Anção ◽  
Clóvis de Araújo Peres ◽  
Álvaro Nagib Atallah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Surgery ◽  
Pulmonary Disease ◽  
Pulmonary Complications ◽  
Smoking Habits ◽  
Chronic Pulmonary Disease ◽  
Postoperative Pulmonary Complications ◽  
Upper Abdominal Surgery ◽  
Duration Of Surgery ◽  
Upper Abdominal

OBJECTIVE: To investigate associations between preoperative variables and postoperative pulmonary complications (PPC) in elective upper abdominal surgery. DESIGN: Prospective clinical trial. SETTING: A tertiary university hospital. PATIENTS: 408 patients were prospectively analyzed during the preoperative period and followed up postoperatively for pulmonary complications. MEASUREMENTS: Patient characteristics, with clinical and physical evaluation, related diseases, smoking habits, and duration of surgery. Preoperative pulmonary function tests (PFT) were performed on 247 patients. RESULTS: The postoperative pulmonary complication rate was 14 percent. The significant predictors in univariate analyses of postoperative pulmonary complications were: age >50, smoking habits, presence of chronic pulmonary disease or respiratory symptoms at the time of evaluation, duration of surgery >210 minutes and comorbidity (p <0.04). In a logistic regression analysis, the statistically significant predictors were: presence of chronic pulmonary disease, surgery lasting >210 and comorbidity (p <0.009). CONCLUSIONS: There were three major clinical risk factors for pulmonary complications following upper abdominal surgery: chronic pulmonary disease, comorbidity, and surgery lasting more than 210 minutes. Those patients with three risk factors were three times more likely to develop a PPC compared to patients without any of these risk factors (p <0.001). PFT is indicated when there are uncertainties regarding the patient’s pulmonary status.

Incidence and risk factors for postoperative pulmonary complications in elective intracranial surgery

2008 ◽  
Vol 109 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Luciana Carrupt Machado Sogame ◽  
Milena Carlos Vidotto ◽  
José Roberto Jardim ◽  
Sonia Maria Faresin
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Prolonged Mechanical Ventilation ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Duration Of Surgery ◽  
Level Of Consciousness ◽  
Type Of Surgery

Object It has been shown that craniotomy may lead to a decrease in lung volumes and arterial blood gas tensions as well as a change in the respiratory pattern. The purpose of this study was to determine the incidence of postoperative pulmonary complications (PPCs) and the mortality rate in patients who have undergone elective craniotomy and to evaluate the associations between preoperative and postoperative variables and PPCs in this population. Methods Two hundred thirty-six patients were followed up based on a protocol including a clinical questionnaire, physical examination and observation of clinical characteristics in the preoperative period, type of surgery performed, duration of surgery, time spent in the intensive care unit (ICU) and hospital, and the occurrence of any PPCs. Results Postoperative pulmonary complications occurred in 58 patients (24.6%) and 23 other patients (10%) died. Predicting factors for PPCs according to multivariate analyses were as follows: type of surgery performed (p < 0.0001), prolonged mechanical ventilation ≥ 48 hours (p < 0.0001), time spent in the ICU > 3 days (p < 0.0001), decrease in level of consciousness (p < 0.002), duration of surgery ≥ 300 minutes (p < 0.01), and previous chronic lung disease (p < 0.04). Conclusions The incidence from March 2003 to March 2005 of PPCs in patients who had undergone craniotomy was 25% and death occurred in 10%. Some risk factors for PPCs may be predicted such as the type of surgery performed, prolonged mechanical ventilation, a longer time in the ICU, a decreased level of consciousness, duration of surgery, and previous chronic lung disease.

scholarly journals Severe pulmonary complications after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are common and contribute to decreased overall survival

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261852
Author(s):  
Olivia Sand ◽  
Mikael Andersson ◽  
Erebouni Arakelian ◽  
Peter Cashin ◽  
Egidijus Semenas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Pulmonary Complications ◽  
Diaphragmatic Injury ◽  
University Hospital ◽  
Full Thickness ◽  
Postoperative Pulmonary Complications

Background and objectives Extensive abdominal surgery is associated with the risk of postoperative pulmonary complications. This study aims to explore the incidence and risk factors for developing postoperative pulmonary complications after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy and to analyze how these complications affect overall survival. Methods Data were collected on 417 patients undergoing surgery between 2007 and2017 at Uppsala University Hospital, Sweden. Postoperative pulmonary complications were graded according to the Clavien-Dindo classification system where Grade ≥ 3 was considered a severe complication. A logistic regression analysis was used to analyze risk factors for postoperative pulmonary complications and a Cox proportional hazards model to assess impact on survival. Results Seventy-two patients (17%) developed severe postoperative pulmonary complications. Risk factors were full thickness diaphragmatic injury and/or diaphragmatic resection [OR 5.393, 95% CI 2.924–9.948, p = < 0.001]. Severe postoperative pulmonary complications, in combination with non-pulmonary complications, contributed to decreased overall survival [HR 2.285, 95% CI 1.232–4.241, p = 0.009]. Conclusions Severe postoperative pulmonary complications were common and contributed to decreased overall survival. Full thickness diaphragmatic injury and/or diaphragmatic resection were the main risk factors. This finding emphasizes the need for further research on the mechanisms behind pulmonary complications and their association with mortality.

scholarly journals The Incidence and Risk Factors of Postoperative Pulmonary Complications in Restrictive Pulmonary Disorders

2019 ◽  
Author(s):  
Oya BAYDAR ◽  
Ezgi OZYILMAZ ◽  
Alper AVCI ◽  
Yasemin SAYGIDEGER
Keyword(s):  
Risk Factors ◽  
Blood Gas Analysis ◽  
Pulmonary Complications ◽  
Gas Analysis ◽  
Blood Gas ◽  
Postoperative Pulmonary Complications ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Duration Of Surgery

Abstract Background The incidence of postoperative pulmonary complications (POPCs) in restrictive pulmonary disorders remains indefinite especially in adults. Therefore, this study is structured to evaluate the incidence and risk factors of POPCs in restrictive pulmonary disorders. Methods 2177 preoperative consultations have been prospectively evaluated from May 2015 to May 2016 in Cukurova University, Department of Chest Diseases. 60 of them (2.8%) met restrictive pulmonary function tests (PFTs) criteria and all of them were enrolled in the study. Each participant was evaluated at the 7th day and has been followed-up until 30th day after surgery. Clinical, surgical, PFT and arterial blood gas analysis parameters were evaluated to analyse risk factors of POPCs. Results The incidence of early and late POPCs as 10% and 11.7% in restrictive pulmonary disorders. Preoperative PaO2 ≤ 68 mmHg is an independent risk factor of POPCs. Surgery site, duration of surgery, age, previous or current smoking, preoperative PFT results, physical status, cardiopulmonary risk points, abnormal chest radiography were not significantly related with an increased risk in our study. Conclusions The incidence of POPCs in restrictive pulmonary disorders is high. The patients with restrictive pulmonary disorders should be evaluated with particular care perioperatively. Arterial blood gas analysis may give additional knowledge about increased POPCs risk.

Identification of the Risk Factors of Postoperative Pulmonary Complications in Elderly Patients Undergoing Elective Colorectal Surgery

2020 ◽  
pp. 000313482095030
Author(s):  
Jun Chai ◽  
Aming Sang ◽  
Meiyue Tan ◽  
Bo Long ◽  
Lina Chen
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Myocardial Ischemia ◽  
Elderly Patients ◽  
Pulmonary Complications ◽  
Older Age ◽  
Pulmonary Diseases ◽  
Postoperative Pulmonary Complications ◽  
Elective Colorectal Surgery ◽  
Independent Risk Factors

Objective This study was to identify the perioperative related risk factors of postoperative pulmonary complications (PPCs) in elderly patients undergoing elective colorectal surgery, which will provide new insight for better prevention and intervention of PPCs in elderly patients. Methods A retrospective study involving 445 patients (age ≥65), who registered in Shengjing Hospital affiliated to China Medical University for elective colorectal surgery from October 2014 to March 2017, was conducted. Clinical data, including demographic information, medical history, preoperative examination, and surgery-related factors, were analyzed and compared between the patient group with PPCs and the group without PPCs. t-test or χ2 test was performed for statistical analysis between the 2 groups. Binary logistic regression analysis was further employed to identify the potential independent risk factors of PPCs. Results Among the 445 patients enrolled in the study, 49 (11%) had PPCs, while 396 (89%) did not. The main risk factors of PPC occurrence in the elderly patients undergoing elective colorectal surgery included older age (age ≥75 years), ASA >II, hypertension, myocardial ischemia, basic pulmonary diseases, laparotomy, blood transfusion, preoperative hemoglobin <100 g/L, and albumin <35 g/L. Laparotomy (compared with laparoscope) and ASA >II were independent risk factors for the increased incidence of PPCs. Conclusion More attention should be paid to patients with older age and ASA >II in elective colorectal surgery. Choice of laparoscopic operation, proper treatment of hypertension, myocardial ischemia, basic pulmonary diseases, and correction of anemia and nutritional status can effectively reduce the incidence of PPCs. An adequate and comprehensive evaluation of the potential risk factors related to PPCs is required before surgery.

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